go back

Arizona rates for HCPCS Q5111

Injection, pegfilgrastim-cbqv (Udenyca), biosimilar, 0.5 mg

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.62 / $235.91 / $6,693.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $107.40 / $994.75
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.04 / $163.25 / $163.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.83 / $388.12 / $832.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.08 / $118.67 / $143.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.33 / $106.33 / $149.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $106.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$136.04 / $158.63 / $523.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.04 / $136.04 / $417.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.33 / $106.33 / $112.71